ATtrial Supply oHeart

SVC

aat (ovoa)
AS diug
Aatey rta.
Ar

let (orOnany
Sino- Aial
Noda SA Crtumb Arery
Arey Nocde
-Let marginal Avhex
Diagonal Artery
Ant. interen+ritular
Ate

Margina
Bacncn. Pastenia intewentritudaYAHe
Heat is Supplied wo coronaryY Ceies . Boh

aasin abcenoing aota amdl YUM M tOvonary

Suutus.

Teatwrs.
glooo Hows hog s e artna dur iawtal
Ha
Diamer (S S. mm.

t ovonar arhe îscuqer in toilre and uppltes

mOve myocarciuM

(0mnary artit ae
umthiona n aties Thouah
qn anuhomusis aowol
but
nca fompentat ote
orte
hmbodis.
 0g PoSt. intewentilar detemlne +a
ate
dominat oatey
aateies
Sqmpaahc
Symputhehc
SHmuuakon ilutes H e i b a -masular

omd
md conticts th pitcrclal aateies.

Let (oonary
Pgnt (oonary Artery
Avte
Smauler
+ndm 1et CA
lasger nan Pnt C.A
Anterior aoric sd oxgun -Let posterio
0rgn
SinUs Suutus.

ourse Couie_ Runs k a d .

YwardS, hem downwads
Puns ues dntiar inkewentiular

i+ winds bdmch. Ten yus ind

IM PAynt Coyunay suus,
ytumol Cmd Tecohi) diaphrogmaHC t anteiay covonay ultus

Surate and eaah upto Post. wtnds voumd ht border

hat amd nou (ado
ntowenicular grtoue.
amd
Uwwm u astey
Termunahm
B4 ancuormaing witn irum eoaM Postinterventvicula

9300ye.
Rrae ok letCoonar avk Teminolhan

Br anches 3 CAap tomosing wiH

Avt t cosonary ate
4 i a Branones P o s
Lt
SA. Nodal A.
A d . intewen iudoy Bzemdh
anteial
t (onun A. tums ttdiagona A.
caled
ru aoud pum.Trunlc Saptl Branehes.
Annudus of Vieus e . Clet tonus. A.
At. qou
t e i w l a oanaines fost.qoup.
Urumu Braen
Rlg Maqinal Ate ma»tnal.
Pos. jttweniwur a a .
CAtit BT.Poc lodel
 Area
disibuhaM Ave oDisbuho
- (2iqt
AMwM Atium
Veices Yenides
pa igt
Vente etcp ave adaig U io etept am
th amltiY iwtven Molauy aalivo post- JmterjenhM.
quove - Cudun
-Swaul paot Venuu uove.

oosivaro H pott. intvewnila -

A pat ok intowe-
9oeve -CUlaa
SRptumM
- Past 2ol Paot a Sree
pat o iwewn ulauY

AV Buwlle
who Canduting syto
Stcept t Bran A tundlte.

-S Nocl i spu'zol l t Coono

At in 40 Y -C ape
 CARDIAC DOMINANCE
In about 10%ofhearts, the right coronary is rather small
and is not able to give the posterior interventricular
branch. In these cases, the circumflex artery, the
continuation of left coronary, provides the posterior
interventricular branch as well as to the AV node. Such
cases are called left dominant.
Mostly, the right coronary gives posterior inter-
ventricular artery. Such hearts are right dominant. Thus
the artery giving the posterior interventricular branch
is the dominant artery.
 ot
Incomplete obstruction, usually due to spasm
which
the coronary artery causes angina pectoris,
is associated with agonising pain in the precordial
region and down the medial side of the left arm
CINICAL ANATOMY and forearm (Fig. 18.26). Pain gets relieved by
, Thrombosis of coronary artery is a common cause putting appropriate tablets below the tongue.
determines the site(s) of
of sudden death in persons past middle age. This Coronary angiography
narrowing or occlusion of the coronary arteries
is due to myocardial ischaemia infarction and
ventricular fibrillation (Fig. 18.25). or their branches.
Angioplasty helps in removal ofsmall blockage.
It is done using small stent or small inflated
balloon (Fig. 18.27) through a catheter passed
upwards through femoral artery, aorta, into the
coronary artery.
If large segments or multiple sites of
there are

blockage, coronary bypass is done using either

great saphenous vein or internal thoracic artery
as grafts) (Fig. 18.28)

Fig. 18.25: Myocardial infarction due to biockage of anterior

interventricular branch of left coronary artery Fig. 18.27: Stent passed in the blocked coronary artery

Precordium

Internal
mammary
Heart Venous graft artery grat

Site of Arterial graft

blockage
Medial side
of left upper imb

Fig. 18.28: Grats put beyond the site of biockage

g.18.26: Pain of angina pectoris felt in precordium and

aang medial border of left arm